TOMAS NGUYEN
Dependent on policy B10M000614
Claims
2
Attributed to this person
Charged
320.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
36.45
Reported on the 835
Patient responsibility is the amount reported on the 835 as assigned to the patient — deductible, coinsurance or copay. It is not proof that the provider billed the member, that the member owes it, or that it was collected, and it is kept separate from denied amounts throughout.
Who this is
| Field | Value |
|---|---|
| Name | TOMAS NGUYEN |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000614 |
| Date of birth | 26 Sep 1981 |
| Plan | SILVER HMO |
| Covered from | 8 Dec 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 36.45 |
| Total | 36.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002561 | 7 Sep 2025 | 243.00 | CASCADE CARE | Not denied | — |
| CLM0002560 | 27 Feb 2025 | 77.00 | CASCADE CARE | Not denied | — |